MEDICARE: NEW BEGINNINGS CDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588931851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEGINNINGS CDS

Provider Business Mailing Address
First Line	:	9374 OLIVE BLVD
Second Line	:	STE 101
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3253
Country	:	US
Telephone Number	:	314-993-5580
Fax Number	:	314-991-7745

Provider Business Practice Location Address
First Line	:	9374 OLIVE BLVD
Second Line	:	STE 101
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3253
Country	:	US
Telephone Number	:	314-993-5580
Fax Number	:	314-991-7745

Authorized Official
Title or Position	:	CEO
Name	:	MISS GLENDA FAYE WHITE
Credential	:	BSN, RN,
Telephone Number	:	314-993-5580

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	11/30/2011

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Directions to “NEW BEGINNINGS CDS ” Practice Location

Language	Start Address	Practice Location

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